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<p>Understanding of pathologic findings associated with the severity and chronicity of drug-induced liver injury (DILI) remains limited. We explored pathologic findings associated with the severity and chronicity in a biopsy-based cohort. We reevaluated medical records and liver histology of hospitalized patients clinically diagnosed with DILI. The severity was classified into five grades; among 301 DILI patients, only eight patients presented with acute liver failure, but no one died. Grades 3–4 were associated with confluent necrosis, ductular reaction, a higher grade of cholestasis and fibrosis, whereas grades 1–2 were associated with the presence of granulomas. 244 patients achieved biochemical normalization within 6 months, 31 patients within 1 year, 17 within 2 years, and 3 within 3 years. This study demonstrated that specific histological features are associated with the severity and chronicity of DILI. Importantly, an interlobular duct loss &gt;25% seems to be an early risk factor for continued biochemical abnormalities.</p>

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Specific clinicopathologic findings are associated with the severity and chronicity of drug-induced liver injury among hospitalized patients

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月3日

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  • Ting Zhang,
  • Mengqi Li,
  • Yidi Ge,
  • Xiaoying Teng,
  • Hong Zhao,
  • Hanlin Wang,
  • Xingang Zhou,
  • Wen Xie

摘要

Understanding of pathologic findings associated with the severity and chronicity of drug-induced liver injury (DILI) remains limited. We explored pathologic findings associated with the severity and chronicity in a biopsy-based cohort. We reevaluated medical records and liver histology of hospitalized patients clinically diagnosed with DILI. The severity was classified into five grades; among 301 DILI patients, only eight patients presented with acute liver failure, but no one died. Grades 3–4 were associated with confluent necrosis, ductular reaction, a higher grade of cholestasis and fibrosis, whereas grades 1–2 were associated with the presence of granulomas. 244 patients achieved biochemical normalization within 6 months, 31 patients within 1 year, 17 within 2 years, and 3 within 3 years. This study demonstrated that specific histological features are associated with the severity and chronicity of DILI. Importantly, an interlobular duct loss >25% seems to be an early risk factor for continued biochemical abnormalities.